Healthcare Provider Details

I. General information

NPI: 1659528362
Provider Name (Legal Business Name): TODAY'S VISION CONROE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 N LOOP 336 W SUITE 150
CONROE TX
77304-3566
US

IV. Provider business mailing address

2257 N LOOP 336 W SUITE 150
CONROE TX
77304-3566
US

V. Phone/Fax

Practice location:
  • Phone: 936-788-2601
  • Fax: 936-788-2601
Mailing address:
  • Phone: 936-788-2600
  • Fax: 936-788-2601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6887T
License Number StateTX

VIII. Authorized Official

Name: DR. GREGORY M. BREAUX
Title or Position: OD
Credential: OD
Phone: 713-995-0042